Goldson A F, Alexander G A, Mahan D G, Henschke U K
J Natl Med Assoc. 1978 Jan;70(1):51-4.
The technique of remote afterloading for intracavitary radiotherapy was developed by Henschke et al 15 years ago, and since then the technique has received wide acceptance, both abroad and in the United States. Here at Howard University, it plays an integral part in the intracavitary portion of the treatment of cervix carcinoma. Most applications are done on an outpatient basis without anesthesia or sedation. This has become possible by dilating the cervical canal painlessly with thin laminaria rods. Spread of the lateral colpostats is accomplished by inflating a Foley balloon secured to the applicator with contrast medias, instead of using the customary gauze packing for increased rectal distance.A single cobalt-60 source of 1 mm diameter and 3 to 7 Curies is used, which can be moved during the treatment to simulate linear sources of different lengths and loading. Our present treatment policy calls for 4,000 rad given to the whole pelvis in 20 fractions of 200 rad three times per week plus eight fractions of 400 rad by the remote afterloading technique given one fraction per week concomtant with the external irradiation. Only 18 patients have been treated to date with minimal adverse tissue reactions. There is only an 18-month maximum follow-up, so survival figures are still pending but all patients so treated are currently living without recurrence.
腔内放射治疗的后装遥控技术是15年前由亨施克等人研发的，从那时起这项技术在国外和美国都得到了广泛认可。在霍华德大学，它在宫颈癌治疗的腔内部分发挥着不可或缺的作用。大多数治疗都是在门诊进行，无需麻醉或镇静。通过使用细的海藻棒无痛扩张宫颈管，这已成为可能。侧置阴道施源器的展开是通过向固定在施源器上的弗利导尿管球囊内注入造影剂来完成的，而不是使用传统的纱布填塞来增加直肠距离。使用一个直径1毫米、活度为3至7居里的钴-60源，在治疗过程中该源可以移动，以模拟不同长度的线性源并进行加载。我们目前的治疗方案要求对整个盆腔给予4000拉德的剂量，分20次，每次200拉德，每周三次，外加通过后装遥控技术给予8次，每次400拉德，每周一次，与外照射同步进行。到目前为止，仅对18例患者进行了治疗，组织不良反应极小。最长随访时间仅18个月，因此生存数据仍未确定，但所有接受这种治疗的患者目前均无复发存活。
